What a doctor may miss when he reaches for the MRI first

Two different cases reflect a phenomenon that some prominent medical educators say has become increasingly commonplace as medicine becomes more technology-driven: the waning ability of doctors to use a physical exam to make an accurate diagnosis. Information gleaned from inspecting blood vessels at the back of the eye, observing a patient's walk, feeling the liver or checking fingernails can provide valuable clues to underlying diseases or incipient problems, they say. But over the past few decades the physical diagnosis skills that were once the cornerstone of doctoring have withered, supplanted by a dizzying array of sophisticated, expensive tests.